Providers are the companies and government agencies that offer insurance plans to the public. Services and coverage vary based on your location, needs, and eligibilities. There are two major types of providers. Twenty five years ago, almost all health insurance providers offered indemnity insurance. Indemnity insurance lets you choose any doctor, hospital or other provider, in exchange for paying a yearly premium. You then pay a much smaller portion of medical costs, say 20%, when you require treatment. The provider pays the remainder of the balance, and then 100% of subsequent charges. Rising medical costs forced insurers to raise deductibles on these plans, making them less affordable for the public. In answer, managed care systems emerged, and today it's estimated that over 75% of insured Americans are part of a managed care plan. Health Maintenance Organizations (HMO) like Kaiser Permanente concentrate on reducing health care inefficiency in order to reduce costs for the consumer. As the industry evolves, Preferred Provider Organizations (PPO) like BlueCross BlueShield, Aetna, and Health Net, as well as Point-of-Service (POS) plans, function as hybrids between indemnity and HMO products. They empower people to choose the practitioner they want, while still allowing the option to take advantage of HMO guidelines.
Don't let choosing a plan confuse of intimidate you. Know your health needs and your budget, then choose accordingly. Choose complimenting services as you need them. Be skeptical of any insurer charging application fees. If you're of low income or over 65, take advantage of government sponsored Medicare and Medicaid programs. If you know that you are going to require regular health treatments of any sort, this is the greatest reason to be insured.
